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Friday, November 6, 2015

Medical Spanish: Where Are We Now?

by Ann Abbott

More and more I come to the conclusion that approaches like "Medical Spanish," "Business Spanish" or "Spanish for Social Workers" is the wrong approach at the undergraduate level at a university like mine, the University of Illinois, Urbana-Champaign. I have written about this (see especially my 2014 with Barbara Lafford and Darcy Lear). It's too soon to specialize. It's useless to memorize long lists of overly-specific vocabulary that students might or might not use in the future. (Who knows if they'll even be accepted into medical school? Or get a job in marketing? Or stick around in social work for more than a couple of years?)

What we could do--and do very well--is the following:

Spanish language. Work on students' Spanish proficiency. There is no magic bullet, but our classes should be designed to help students along that path and study abroad (especially one-year programs) should be encouraged.

Community-based learning. Students should do community service learning. If they can do it in a medical setting (if they are interested in medical Spanish), great. But even if they work in another professional setting, they will still be well served by learning all the foundational vocabularly and professional behaviors that must happen in all professional settings. Mostly, they will gain a deeper understanding of the Spanish-speaking individuals who are the patients (or any other number of roles they play) students imagine themselves having one day. They will also, hopefully, gain a fuller understanding of issues concerning immigrant communities--structural and political issues--that go far beyond a list of medical terms yet have a huge impact on their health and their access to health care.

Being a bilingual professional. Equip our students with an understanding of the unique responsibilities and skills required of bilingual professionals--whatever the profession. They should learn some fundamentals about interpreting and translation, especially the ethical questions involved. They should understand the mental strain and time commitment of being a (the only?) bilingual in their office. (Lissette Piedra and Glenn Martinez's work is important here.) They should understand the institutional pressures they will feel to often play a role for which they are not entirely prepared. (Soria Colomer's work is important here.) They need an understanding of the policies that shape the realities of many Latinos' lives. (I'm working on a chapter about this.) They need to be trained in how to be resourceful language learners after they graduate--and how to critically evaluate the language tools they might turn to. And so much more!

We already have many, thought not all, of these components in our curriculum, but we have yet to put them together into a coherent whole. And many of the courses students would actually need to accomplish this "don't count" for the major/minor.

So that's where we are. Close, but not there. We need to clarify--and offer!--courses that explicitly build their general proficiency and their knowledge of how to be a good advocate for Spanish-speaking patients (or clients, or service recipients, etc.) by understanding their lives far beyond a list of medical symptoms.

For the sake of our truly wonderful students who learn Spanish in large part to build better relationships with and responses to our Latino communities throughout their careers, I hope that we can move forward. I'm including here an email conversation with a very good student to highlight some of the issues and to show what can be done even now, even with an imperfect "course-based" approach to Medical Spanish.

Student email

Querida Profesora
Abbott,

Greetings from Quito, Ecuador! How
are you? I write you to update you on my experiences thus far being
abroad and also to inquire about the potential for the Spanish for medical
professionals course next Spring. I just passed the halfway mark of my
semester abroad in Ecuador and it's sad to think I have less than 2 months left
here. Four months is not enough time, but now I have an excuse to come
back to South America :) ! That being said, I have truly enjoyed the
first few months of being here and have fallen in love with the culture, people
and natural beauty of Ecuador. I feel I have a strong relationship with
my host family, I have increased my fluency in Spanish and I have found a way
to combine my two passions of speaking Spanish and helping others at a free
public health clinic in Tumbaco, Ecuador. Seeing that I only have one
more semester left at the university, I am currently constructing my class
schedule for the Spring and I was wondering, will the Spanish department be
offering a course for medical professionals next semester? If so, I would
love to be apart of it. If not, do you have any suggestions for me on how
I can use my Spanish and my medical / public health experiences in the
community next semester? I know that you are connected with several community
organizations and I would be interested in volunteering or interning on my own
time for any group in the Champaign-Urbana community. As a side note, I
have signed up for your Spanish and Entrepreneurship course and look forward to
taking the course with you. Finally, I was hoping to get involved in
research next semester. If you are aware of any professors or graduate
students working on projects or papers involving health care, public health,
Spanish, health communication interpretation, etc - would you mind passing
along their names to me? I would greatly appreciate it.

Saludos,

[student]

My response

[Another student] is working on putting together a special section of SPAN 232. If she gets enough enrollment, I’ll try to offer it. But since you already took the course, I don’t think you can repeat it. How about working with me to personalize your assignments in SPAN 332 so that you can do the kind of learning you want about what you want?

For SPAN 332, you can definitely work in a hospital or clinical setting here. I’m copying [yet another student] here; she is currently working at Presence hospital in SPAN 232, and maybe you could ask her questions about that.

In the Spanish department, we don’t have anyone that I know of who works on those issues. In the School of Social Work, Prof. Lissette Piedra does fascinating work on mental health and Latinas. I would also be open to doing an independent study with you; maybe you could create a case study about Latino health issues in Champaign-Urbana.